Comparing Uniplanar and Multiaxial Pedicle Screws in the Derotation of Apical Vertebrae for Lenke V Adolescent Idiopathic Scoliosis (AIS): A Case Controlled Study.

Comparing Uniplanar and Multiaxial Pedicle Screws in the Derotation of Apical Vertebrae for Lenke V Adolescent Idiopathic Scoliosis (AIS): A Case Controlled Study.

World Neurosurg. 2017 Dec 28;:

Authors: Lin T, Li T, Jiang H, Ma J, Zhou X

Abstract
OBJECTION: To compare the use of uniplanar and multiaxial pedicle screws in terms of their effects on the apical vertebral derotation efficiency in Lenke V AIS patients.
METHODS: A retrospective study was performed, and Lenke V AIS patients with uniplanar pedicle screws (Group I) and multiaxial pedicle screws (Group II) were collected from Jan 2013 to Dec 2015. The grade of the apical vertebral rotation was evaluated before and after surgery using the Nash-Moe and Upasani methods, respectively. The SRS-22 scale was also used to evaluate the satisfaction of the patients.
RESULTS: There were no significant differences in terms of age, duration of follow up, correction ratio, and preoperative level of apical rotation between both groups (p<0.05). Group I indicated better apical vertebral derotation than Group II (0 level: 10.5% versus 2.3%, I level: 71.1% versus 38.6%, II level: 18.4% versus 59.1%; p=0.001). The progression group showed lower bone maturity (p<0.0001, OR=52.0, 95%CI: 6.3∼430.7) in Group I, and similar results were observed in Group II (p=0.057, OR=12.3, 95%CI: 1.3∼121.3). Patients from Group I showed better satisfaction than those from Group II based on the SRS-22 scores (p<0.05).
CONCLUSION: Both types of pedicle screws could provide effective correction, but the uniplanar pedicle screw was better for derotation of vertebrae and provided patients with better satisfaction. Skeleton immaturity was positively correlated with the progression of vertebral rotation after surgery.

PMID: 29289805 [PubMed - as supplied by publisher]

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